ARTICLEPSORIASIS

The Truth Behind the Benefits of Fish Oil for Psoriasis

By Kelly Bryant

Reviewed by Allison Truong, M.D.

June 08, 2021

For people with psoriatic disease, there’s some talk about whether a fish oil supplement, rich in omega-3s, can help improve their symptoms. Though there are scientific studies that suggest fish oil is helpful for psoriasis, there are some things you should know before adding the supplement to your daily regimen. To find out more, we asked Elizabeth DeRobertis, a New-York based registered dietitian, for her take on fish oil and its potential benefits for psoriasis and psoriatic arthritis.

What exactly is fish oil?

Fish oil is derived from the tissue of oily fish. It’s a dietary source of omega-3 fatty acids. We need omega-3 fatty acids for many functions, from muscle activity to cell growth. Omega-3 fatty acids can't be manufactured in the body, and we can only get them through food.

The two active components of fish oil are DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). Dietary sources of DHA and EPA are fatty fish, such as salmon, mackerel, and trout; and shellfish, such as mussels, oysters, and crabs. Some nuts, seeds, and vegetable oils contain another omega-3 called ALA (alpha-linolenic acid).

Why do we hear about fish-oil supplements for psoriasis so often?

People often want a natural solution without side effects, or something to supplement medications they’re taking hoping for enhanced benefits.

It’s been found that psoriasis is less common in certain areas, like West African countries, where cold-water fish containing omega-3 fatty acids make up a significant part of the regional diet. This finding led researchers to look into a potential link between omega-3s and psoriasis.

Omega-3s have strong anti-inflammatory properties. A comprehensive literature review published in the Journal of the American Academy of Dermatology found that omega-3 fatty acids helped to improve psoriasis symptoms in 12 out of 15 trials.

There are many vitamins, minerals, and supplements that have been tested to see if they’re effective in helping to reduce psoriasis symptoms and flares. Of all that have been tested, it seems that there is the most evidence for the support of fish oil in helping with psoriasis. The review I mentioned weighed evidence from both controlled and uncontrolled prospective trials. The evidence of benefit among all the supplements reviewed was highest for fish oils.

What about psoriatic arthritis—is there any evidence fish oil helps with those symptoms, as well?

Yes, but this is controversial because there are studies on both sides: Some have shown fish oil to be helpful for psoriatic arthritis, and others have not. The studies that support that fish oil is beneficial for psoriatic arthritis say it may help to reduce inflammation, and thereby ease discomfort for some people.

A randomized, double blind, placebo-controlled trial of 145 people with psoriatic arthritis receiving 3 grams of n-3 polyunsaturated fatty acids per day compared to olive oil showed no statistical significance between the groups. But it did show that the group taking fish oil took fewer pain medications (non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen). In another study, researchers found a possible cardio-protective effect of fish oil on patients with psoriatic arthritis.

If someone with psoriasis or psoriatic arthritis wants to take a fish oil supplement, what kind and how much should they take?

To get the benefits of omega-3s, people should make sure their supplements contain a balance of EPA and DHA. This is present in most fish-oil supplements. The recommended dosage is typically 1 gram per day (or 1,000 mg). Some doctors recommend up to 3 grams per day. It’s important to not take more than this amount without consulting a doctor, as fish oil is also a blood thinner.

When looking at a supplement, check the label to make sure that DHA and EPA make up most of the 1,000 mg dosage. Some products have fillers, and, therefore, are less effective.

Eight to 12 weeks should be enough time to notice any benefit from taking fish oil. Many studies show that fish oil is at its most effective when taken for three months or longer, so you may not notice positive effects right away. Take omega-3 supplements during or right after a meal to maximize its absorption into the body.

Are there any potential side effects to taking fish oil?

Fish-oil supplements usually only cause side effects if they’re consumed at high doses. Mild symptoms can include a fishy aftertaste, heartburn, and nausea. Fish oil affects blood clotting, so if you're taking blood-thinning medication, talk with your doctor before trying it. Given that fish oil can potentially lead to increased bleeding, it’s a good idea to talk with your doctor to see if you should stop taking fish oil at least one week prior to any surgery or procedure.

What else should someone know about taking fish oil for their psoriasis or psoriatic arthritis?

Many research studies give participants high omega-3 doses, or administer omega-3s via injections or intravenous drips (IVs). The results from some of the studies do not always reflect what people may experience from regular oral supplementation. And it’s not necessarily safe to take this dosage on your own without consulting your doctor.

The first step should be to work with your doctor to find a safe dosage for you. Next, make sure the supplement is primarily made from EPA and DHA. Third, find one that you can tolerate. Enteric-coated fish oil pills will stay intact until they are in the intestines, so they’re less likely to cause heartburn and fishy burps.

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